Surgical Case- Burst Abdomen
Nov 05 2022 | Medicover Hospitals
A 56-year-old female patient presented to ER with spontaneous abdominal burst and high-grade fever. History says she had severe abdominal discomfort for one month and treated at a private hospital in Vijayawada. She was diagnosed with urinary tract Infection and uremic encephalopathy. She stayed for 12 days and was managed conservatively.
After reaching home, she had an episode of vomiting. Later, she noticed evisceration of bowel loops through previous surgical scar. She was rushed to nearby well-known hospitals at Vijayawada and Eluru. Was denied treatment due to a ssoc i a ted multiple co -morbid conditions and
Covid Positivity: She had a history of congenital heart disease and underwent open heart surgery for valve repair in 2010. Since then, she was on Acitrom tablet. She also had a history of two caesarean sections and operated for incisional hernia one year back.
On arrival: She was dehydrated and dis-oriented, Bp 100/60 mmHg, PR-130/minute, SPo2- 94% with room air, Resp. rate-30/mt. Temp-100*C
On examination, it was observed that she had eviscerated bowel loops in her lap with severe oedema, congestion and discolouration. Further evaluation was done and high-risk outcomes were explained to the patient. She was shifted to emergency operation theatre for surgery.
Intra-OP findings: Showed oedematous bowels outside the abdomen with a loop formation. The following picture shows gangrenous intestine with colour change. Hence, it was resected and double barrel Ileostomy was performed as a First stage surgery.
Remaining intestines were placed inside the abdomen and a polystyrene cover was used as a layer to prevent protrusion of intestines.
She was shifted to ward and treated for covid. After her recovery from Covid, second stage operation was performed and colostomy was created. She was shown to a cardiologist for cardiac related issues. Now, she was stable.
After close observation for 2 months, final stage surgery was performed to close the colostomy and abdomen. Presently she is doing one at her home.